Physical Therapy Intervention for Women With Dyspareunia: A Randomized Clinical Trial

Abstract

Dyspareunia negatively affects women´s quality of life, and is a frequent complaint during the peri- and postmenopausal period. A randomized trial evaluated sexual function, quality of life, pain, and pelvic floor muscle function of climacteric women aged between 40 and 60 years old who were sexually active and had complaints of dyspareunia for at least six months. They were assessed before and after their randomization in one of the following interventions: the first group (n = 21) received five one-hour sessions of thermotherapy for relaxation of pelvic floor muscles, myofascial release, and pelvic training (pelvic floor muscle training—PFMT group). The second group (n = 21) received five one-hour sessions during which heat was applied to the lower back with myofascial release of abdominal diaphragm, piriformis, and iliopsoas muscles, with no involvement of pelvic training (lower back—LB group). Forty-two climacteric women with dyspareunia (mean ± SD, PFMT group: 51.9 ± 5.3 years, LB group: 50.6 ± 4.7 years, Student’s t-test, p = 0.397) were studied. Pain scores (mean ± SEM) in the PFMT group decreased from 7.77 ± 0.38 to 2.25 ± 0.30; and in the LB group from 7.62 ± 0.29 to 5.58 ± 0.49 (generalized estimating equation—GEE model, p ≤ 0.001 for group, time, and interaction pairwise comparisons). Conclusion: The proposed pelvic floor muscle training protocol was effective to improve pain, quality of life, sexual function, and pelvic floor muscle function in climacteric women with dyspareunia.

Acknowledgments

The authors are grateful to Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and to Miotec for partially supporting the present study.

The authors also thank all the researchers from the Climacteric and Menopause Research Group. Additionally, we would like to express our deepest gratitude to the participants for their time and patience throughout this study.

Disclosure Statement

The authors have no conflicts of interest to declare concerning the publication of this article.

Additional information

Funding

This work was supported by grants from the National Counsel of Technological and Scientific Development (CNPq, Brazil), the National Coordination for Improvement of Higher Education Personnel (CAPES, Brazil) and Fundo de Incentivo à Pesquisa e Eventos Hospital de Clínicas de Porto Alegre (Research and Events Incentive Funding; FIPE/HCPA, Brazil).